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Testing for gestational diabetes during the COVID-19 pandemic. An evaluation of proposed protocols for the United Kingdom, Canada and Australia.
McIntyre, H David; Gibbons, Kristen S; Ma, Ronald C W; Tam, Wing Hung; Sacks, David A; Lowe, Julia; Madsen, Lene R; Catalano, Patrick M.
  • McIntyre HD; Mater Research Institute, The University of Queensland, South Brisbane, Australia. Electronic address: David.mcintyre@mater.org.au.
  • Gibbons KS; Mater Research Institute, The University of Queensland, South Brisbane, Australia.
  • Ma RCW; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China; Chinese University of Hong Kong-Shanghai Jiao Tong University Joint Research Centre in Diabetes Genomics and Preci
  • Tam WH; Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, China.
  • Sacks DA; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
  • Lowe J; University of Newcastle, Newcastle, Australia.
  • Madsen LR; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
  • Catalano PM; Department of Obstetrics and Gynecology, Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA.
Diabetes Res Clin Pract ; 167: 108353, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-688787
ABSTRACT

AIMS:

We assessed how altered diagnostic processes and criteria for gestational diabetes mellitus (GDM) recommended by the United Kingdom (UK), Canada and Australia for use during the COVID-19 pandemic would affect both GDM frequency and related adverse outcomes.

METHODS:

Secondary analysis of 5974 HAPO study women with singleton pregnancies who underwent 75 g OGTTs and HbA1c assays between 24 and 32 weeks' gestation and who received no treatment for GDM.

RESULTS:

All post COVID-19 modified pathways reduced GDM frequency - UK (81%), Canada (82%) and Australia (25%). Canadian women whose GDM would remain undetected post COVID-19 (missed GDMs) displayed similar rates of pregnancy complications to those with post COVID-19 GDM. Using UK modifications, the missed GDM group were at slightly lower risk whilst the women missed using the Australian modifications were at substantially lower risk.

CONCLUSIONS:

The modifications in GDM diagnosis proposed for the UK, Canada and Australia result in differing reductions of GDM frequency. Each has both potential benefits in terms of reduction in potential exposure to COVID-19 and costs in terms of missed opportunities to influence pregnancy and postpartum outcomes. These factors should be considered when deciding which protocol is most appropriate for a particular context.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pregnancy Complications, Infectious / Blood Glucose / Diabetes, Gestational / Coronavirus Infections / Pandemics / Missed Diagnosis / Glucose Tolerance Test Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Pregnancy Country/Region as subject: North America / Europa / Oceania Language: English Journal: Diabetes Res Clin Pract Journal subject: Endocrinology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pregnancy Complications, Infectious / Blood Glucose / Diabetes, Gestational / Coronavirus Infections / Pandemics / Missed Diagnosis / Glucose Tolerance Test Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Pregnancy Country/Region as subject: North America / Europa / Oceania Language: English Journal: Diabetes Res Clin Pract Journal subject: Endocrinology Year: 2020 Document Type: Article